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Review
. 2015 Sep;28(3):140-5.
doi: 10.1055/s-0035-1555005.

Combined Endoscopic and Laparoscopic Surgery

Kelly A Garrett  1 , Sang W Lee  1
Affiliations
Review

Combined Endoscopic and Laparoscopic Surgery

Kelly A Garrett et al. Clin Colon Rectal Surg. 2015 Sep.

Abstract

Benign colon polyps are best treated endoscopically. Colon polyps that are not amenable for endoscopic removals either because they are too large or situated in anatomically difficult locations can pose a clinical dilemma. Traditionally the most common recommendation for these patients has been to offer a colon resection. Although the laparoscopic approach has improved short-term outcomes, morbidities associated with bowel resection are still significant. We may be over treating majority of these patients because of the remote possibility that these polyps may be harboring a cancer. A combined approach using both laparoscopy and colonoscopy (combined endoscopic and laparoscopic surgery) has been described as an alternative to bowel resection in select patients with polyps that cannot be removed endoscopically. Polyp removal using this combined approach may be an effective alternative in select patients.

Keywords: Laparoscopic-assisted endoscopic polypectomy; benign polyps; combined endoscopic and laparoscopic surgery.

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Figures

Fig. 1
Fig. 1
Suggested trocar and monitor placement for CELS technique for excision of a right colon polyp.
Fig. 2
Fig. 2
Endoscopic visualization of a right colon polyp.
Fig. 3
Fig. 3
Endoscopic visualization of a colon polyp with simultaneous laparoscopic manipulation of the colon wall.
Fig. 4
Fig. 4
Laparoscopic manipulation of the polyp during a snare polypectomy with laparoscopic delivery of the polyp into the snare.
Fig. 5
Fig. 5
Suture reinforcement of the colon in an area of partial-thickness injury.
Fig. 6
Fig. 6
Sleeve resection of a polyp in the cecum using a laparoscopic linear stapler.
See this image and copyright information in PMC

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